Indiana Self Insurers Association, Inc.

NOTICE OF TERMINATION – FORM 38911

Form 38911 must be electronically filed per the Board’s EDI 3.1 protocol. The date upon which such filing occurred or was first attempted is considered by the Board to be the filing date.  And, Form 38911 is statutorily required to be served upon the employee whose temporary total or temporary partial disability compensation is being terminated.  If the employee is represented by counsel, then the employee’s attorney should also be served.

The Indiana Worker’s Compensation Board has announced that as of April 1, 2020, it will begin evaluating the filing of Indiana State Form 34401, Indiana Worker’s Compensation First Report of Employee Injury, Illness for timeliness and will issue penalties for those reports which are untimely.

What is the time for filing?  An employer which is insured for worker’s compensation must provide a report concerning a work-related injury or illness to its insurance carrier within 7 days after the employer’s knowledge of the injury or illness, either actual or alleged.  Then, the insurance carrier must file Form 34401 within 7 days after receipt or 14 days after the date of the employer’s knowledge, whichever is later. A self-insured employer must provide Form 34401 to the Worker’s Compensation Board within 7 days after the employer’s knowledge of the injury or illness, either actual or alleged.  The report must be submitted pursuant to the Board’s EDI 3.1 procedures.

What is an injury for reporting purposes?  A death or the need for medical care beyond first aid must be reported.  Indiana law also states that the reporting requirement is intended to be consistent with the OSHA reporting requirement established at 29 CFR 1904.7.  This means that reporting is required for death or any injury or illness which causes days away from work, restricted work, transfer to another job, medical treatment beyond first aid, or loss of consciousness.  And, even if none of those events has occurred, reporting is required for a significant injury or illness diagnosed by a physician or licensed health care provider.

What are the penalties?  After notice and a hearing, the Board may assess a civil penalty of $50 for the first violation, $150 for the second unrelated violation, and $300 for the third and subsequent unrelated violations.  

You should look at your reporting practices and procedures now to make sure that timely reporting is a priority.  

The employee claims an accidental injury and that he reported it to his supervisor. The supervisor denies or doesn’t recall having received the claimed report. The case is denied. The employee seeks his own medical care and is recommended to have surgery. The employee tells the employer of that recommendation and asks that the employer provide the recommended treatment. The employer declines to do so. The employee has the surgery and files an Application for Adjustment of Claim. The employee didn’t report the accidental injury and had unauthorized treatment, so why should the employer consider a settlement?

Indiana Code 22-3-3-7 states:  

“Once begun, temporary total disability benefits may not be terminated by the employer unless:” 

1. employee has returned to work, 
2. employee has died, 
3. employee has refused a medical examination or suitable employment, 
4. employee has received 500 weeks of TTD or the maximum compensation, 
5. employee is unable/unavailable for work for reasons unrelated to the injury.  

“In all other cases, the employer must notify the employee in writing of the employer’s intent to terminate the payment of temporary total disability benefits * * * on a form approved by the board.” 

Form 38911 is the form approved by the Board and the TTD may not terminate until four days after Form 38911 has been mailed.  

EDI 3.1

How are you doing with EDI 3.1?  Indiana is one of the first States to implement this reporting format.  Our Indiana Worker’s Compensation Board has tried to limit the information requested and some States ask for even more detail.  If you have any questions or issues with EDI 3.1, please feel free to contact the Indiana Worker’s Compensation Board (David Babcock or Jake Forte) for assistance.  The start date for possible statutory penalties is December 1, 2019.

Linda Peterson Hamilton, Chairman
WORKERS COMPENSATION BOARD
402 West Washington Street, Room W196
Indianapolis, Indiana 46204-2753
Telephone: (317) 232-3808
http://www.in.gov/workcomp

What happens when a child loses a parent to a work-related fatality? What happens when that family’s main source of income ends to their children’s educational opportunities and aspirations?

Kids Chance of Indiana (KCIN) is a non-profit that provides college and vocational scholarships to eligible children of Indiana workers who were totally disabled or fatally injured due to a work-related accident. Established in 1996, KCIN has awarded over 125 scholarships totaling more than $280,000.00, averaging approximately $2,400.00 per student.

But there is so much more we could achieve. KCIN would like to increase the number of scholarships awarded each year and raise the average amount awarded to $5,000.00, thereby further reducing our students unmet needs. It would take an additional $30,000 to $50,000 annually which, with the generosity of potential corporate partners and donors like you, we believe we can realize.

Please consider supporting KCIN as a corporate sponsor or by participating in our golf outing, which is our primary annual fundraiser. Click Read More for additional information regarding that event and sponsorships.

Further if you have a referral or knowledge of a child impacted by a fatal or totally disabling injury of a parent from an Indiana work accident please let me know so we can reach out to them. You can additional information on our website, https://www.kidschancein.org.

Thank you for your consideration and if you interested in sponsoring or have any questions regarding this worthy organization please contact Darren Dye at [email protected] or (317) 233-3394.

Darren Dye
Vice-President Kids’ Chance of Indiana

The Indiana Worker’s Compensation Board is made up of seven persons appointed by the Governor of Indiana.  The seven persons must be Indiana attorneys in good standing and are referred to as members of the Board. One of the members is designated as the chairman of the Board and is primarily responsible for the administration of the Board’s activities.  The remaining six members are assigned to the six Statewide hearing districts and are primarily responsible for the adjudication of compensation disputes in those districts. All seven members constitute the full Worker’s Compensation Board for the purpose of appeals from hearing member awards.

There have been some recent changes in Board members.  Doug Meagher has been appointed to District 5. (This is member Meagher’s second appointment to the Board.)  Kyle Samons has been appointed to District 6. Sandra O’Brien has been appointed to District 1. All three appointees have substantial experience regarding worker’s compensation law and procedure and are excellent additions to the Board.

The Indiana Worker’s Compensation Board website contains guidelines regarding the role of a nurse case manager (NCM) in Indiana worker’s compensation cases.  If you use a NCM in the administration of a worker’s compensation claim, you should be sure that your NCM is aware of and is in compliance with these guidelines in the course of delivering NCM services to your injured employee.